JP2006212178A - Blood pressure-measuring apparatus and blood pressure judgment method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood pressure-measuring apparatus and a blood pressure judgment method, which achieve improved measurement accuracy of blood pressure measurement at a minute part of a part of the external ear. <P>SOLUTION: The blood pressure-measuring apparatus is provided with: two cuffs respectively put on or around the left and right external ears of a living body and for pressurizing the left and right external ears or the peripheries with equal pressing pressure; two pulse wave detection means for respectively detecting pulse waves from the left and right external ears or the peripheries respectively pressed by the two cuffs; a pressure detection means for detecting the pressing pressure to the left and right external ears or the peripheries by the two cuffs; and a blood pressure judging means for judging a systolic blood pressure, a diastolic blood pressure or a heart rate on the basis of the pulse waves detected by the two pulse wave detection means and the pressing pressure detected by the pressure detection means corresponding to the pulse waves in the state of reducing or increasing the pressing pressure to the left and right external ears or the peripheries by the cuffs. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a sphygmomanometer that measures blood pressure and a blood pressure determination method in blood pressure measurement.

  With the aging of society, dealing with adult lifestyle-related diseases has become a major social issue. It is recognized that long-term blood pressure data collection is very important, especially for diseases related to high blood pressure. From this point of view, various biological information measuring devices including blood pressure have been developed.

  2. Description of the Related Art Conventionally, there is a patient monitor device that is inserted into the ear canal and is always worn as a device that measures biological information at the outer ear portion (see, for example, Patent Document 1). This can be calculated from the amount of received light of the scattered light of infrared light and visible light that radiates the pulse, pulse wave, electrocardiogram, body temperature, arterial blood oxygen saturation, blood pressure, etc. into the living body.

  Moreover, as an apparatus to be mounted on the ear canal, there is an emergency information apparatus that includes wireless communication means and includes an arterial blood oxygen saturation sensor, a body temperature sensor, an electrocardiogram sensor, and a pulse wave sensor (see, for example, Patent Document 2). ).

  On the other hand, regarding blood pressure measurement, blood pressure measurement devices based on pulsation waveforms of blood vessels are influential along with other methods such as cuff vibration method and volume compensation method (for example, see Non-Patent Document 1). It is recognized as a method for measuring blood pressure. In the present specification, the names of the outer ears are based on Non-Patent Documents 2 and 3.

JP-A-9-128203 JP-A-11-128174 Kenichi Yamakoshi, Tatsuo Togawa, “Biosensor and Measuring Device”, MM Japan Society / ME textbook series A-1, pages 39-52 Sobotta Illustrated Human Anatomy Volume 1 (Translation by Michio Okamoto), p. 126, Medical School, issued October 1, 1996 The Atlas of Human Body, p. 20, Kodansha Co., Ltd., published on January 29, 2004, 35th edition

  In these research and development, the present inventors have pressed a part of the outer ear of the living body as a sphygmomanometer that can measure blood pressure even in a relatively small living body part such as the tragus of the outer ear, and the pulse wave of the pressurized part. We are working on the development of a sphygmomanometer that detects blood pressure and measures blood pressure.

  However, when a part of a minute part of the outer ear is pressed, a pulse wave signal obtained therefrom is minute compared to a pulse wave detected from a part of a living body such as an arm or a wrist. Therefore, when the pulse wave signal is amplified for signal processing, noise is also amplified at the same time, which may cause an error in blood pressure measurement.

  Therefore, an object of the present invention is to provide a sphygmomanometer and a blood pressure determination method with improved measurement accuracy of blood pressure measurement in a small part of the outer ear.

  In the present invention, in order to solve the above-mentioned problem, the blood pressure is determined from the pulse waves detected by the left and right outer ears or their surroundings.

  Here, “the left and right outer ears or their surroundings” is a part capable of measuring the blood pressure of the head of the living body, and the midplane of the living body (the “sagittal plane” that passes through the center of the body is the midplane 2 points that are substantially symmetrical.

  Specifically, the sphygmomanometer according to the present invention includes two cuffs that are respectively attached to the left and right outer ears of the living body or the periphery thereof, and compress the left and right outer ears or the periphery thereof with an equivalent compression pressure, and the two cuffs. Two pulse wave detection means for detecting pulse waves from the left and right outer ears or their surroundings, respectively compressed, and two pressures for respectively detecting the pressure applied to the left and right outer ears or their surroundings by the two cuffs Corresponding to a pulse wave detected by the two pulse wave detection means and the pulse wave in a state where the compression pressure to the left and right outer ears or the periphery thereof by the two cuffs is reduced or increased Blood pressure determination means for determining systolic blood pressure, diastolic blood pressure or heart rate based on the compression pressure detected by the two pressure detection means.

  In the blood pressure determination means, the validity of each pulse wave signal can be verified in advance by determining the blood pressure from the pulse wave signals obtained from the left and right outer ears or their surroundings. Therefore, the blood pressure monitor according to the present invention has good blood pressure determination accuracy.

  In the sphygmomanometer, the blood pressure determination means determines that an error occurs when a left-right difference in either systolic blood pressure, diastolic blood pressure, or heart rate of the left or right outer ear or its surroundings is equal to or greater than a predetermined threshold value. It is desirable to do.

  It is presumed that the pulse wave signals from the outer ear match in the left and right outer ears or in the vicinity thereof. Therefore, in the blood pressure determination means, by calculating the left-right difference between the systolic blood pressure, the diastolic blood pressure, or the heart rate obtained from the pulse wave signals from the left and right outer ears or the vicinity thereof, the pulse wave signals of each other are calculated. It can be determined whether they match. In addition, the systolic blood pressure, the diastolic blood pressure, or the heart rate can be detected during blood pressure measurement according to the method of blood pressure determination, as will be described later. Therefore, an error in blood pressure measurement is detected at an early stage, and the time required for blood pressure measurement is shortened.

  The predetermined threshold can be set empirically by comparing the difference between the left and right pulse wave signals with the appropriateness of the blood pressure value, for example, from a plurality of blood pressure measurements. The same applies hereinafter.

  In the sphygmomanometer, it is preferable that the blood pressure determination unit determines a blood pressure based on an added value of the pulse wave signals in the left and right outer ears or in the vicinity thereof and the compression pressure.

  It is estimated that the noises of the pulse wave signals from the left and right outer ears or their surroundings are weakly correlated with each other. Since the signal waveform is voltage-added and the noise is power-added, the noise can be offset and reduced by adding both pulse wave signals in the blood pressure determination means. Therefore, the blood pressure monitor of the present invention has good blood pressure determination accuracy.

  The sphygmomanometer may further include a pump connected to the two cuffs to send a gas having the same atmospheric pressure into the two cuffs to increase the compression pressure to the left and right outer ears or the periphery thereof. desirable.

  By providing the pump, the left and right outer ears or their surroundings can be compressed with the same pressure over time. Therefore, the reference of the pulse wave signal in the passage of time can be made equal on the left and right, and it is not necessary to cause the blood pressure determination means to perform processing such as matching the reference of the pulse wave signal to the compression pressure on the left and right in advance. Accordingly, for example, processing such as addition of a pulse wave signal can be easily performed in the blood pressure determination means.

  Further, in the above sphygmomanometer, the compression pressure is applied to the left and right outer ears or the periphery thereof by discharging gas while maintaining the same atmospheric pressure in the two cuffs connected to the two cuffs. It is desirable to provide an electromagnetic valve for reducing the pressure of

  By providing the electromagnetic valve, the pressure applied to the left and right outer ears or their surroundings can be reduced with the same pressure over time. Therefore, the reference of the pulse wave signal in the passage of time can be made equal on the left and right, and it is not necessary to cause the blood pressure determination means to perform processing such as matching the reference of the pulse wave signal to the compression pressure on the left and right in advance. Accordingly, for example, processing such as addition of a pulse wave signal can be easily performed in the blood pressure determination means.

  Also, in the blood pressure determination method according to the present invention, two cuffs that are respectively attached to the left and right outer ears or the periphery thereof and press the left and right outer ears or the periphery thereof with the same compression pressure are applied to the left and right outer ears or the periphery thereof. The pulse waves detected by the two pulse wave detecting means for detecting the pulse waves from the left and right outer ears or their surroundings and the compression to the left and right outer ears or their surroundings in a state where the compression pressure of the left and right outer ears is reduced or increased The blood pressure determination means determines systolic blood pressure, diastolic blood pressure, or heart rate based on the compression pressure detected by the two pressure detection means that respectively detect the pressure corresponding to the pulse wave.

  The blood pressure determination means determines the blood pressure from the pulse wave signals obtained from the left and right outer ears or the vicinity thereof, whereby the validity of each other's pulse wave signals can be verified in advance. Therefore, the accuracy of blood pressure determination can be improved.

  In the blood pressure determination method, the blood pressure determination means may further determine that an error has occurred when a difference between systolic blood pressure, diastolic blood pressure, or heart rate of the left and right outer ears or their surroundings is a predetermined threshold value or more. desirable.

  It is presumed that the pulse wave signals from the outer ear match in the left and right outer ears or in the vicinity thereof. Therefore, the blood pressure determination means calculates the difference between the left and right of the systolic blood pressure, the diastolic blood pressure, or the heart rate obtained from the pulse wave signals from the left and right outer ears or the vicinity thereof, so that the pulse wave signals of each other are calculated. It can be determined whether they match. In addition, the systolic blood pressure, the diastolic blood pressure, or the heart rate can be detected during blood pressure measurement according to the method of blood pressure determination, as will be described later. Therefore, an error in blood pressure measurement can be detected at an early stage, and the time required for blood pressure measurement can be shortened.

  In the blood pressure determination method, it is preferable that the blood pressure determination means determines the blood pressure based on an added value of the pulse wave signals in the left and right outer ears or in the vicinity thereof and the compression pressure.

  It is estimated that the noises of the pulse wave signals from the left and right outer ears or their surroundings are weakly correlated with each other. Since the signal waveform is voltage-added and the noise is power-added, the blood pressure determination means adds both signals to cancel and reduce the noise to improve blood pressure determination accuracy.

  Further, in the blood pressure determination method, a pump connected to the two cuffs and sending a gas having the same atmospheric pressure into the two cuffs sends the gas to increase the pressure applied to the left and right outer ears or the vicinity thereof. It is desirable.

  By sending the gas of the same atmospheric pressure from the pump, the left and right outer ears or their surroundings can be compressed with the same pressure over time. Therefore, the reference of the pulse wave signal over time can be made equal on the left and right sides, and it is not necessary to previously perform processing such as matching the reference of the pulse wave signal with respect to the compression pressure on the left and right in the blood pressure determination means. Therefore, for example, processing such as addition of pulse wave signals in the blood pressure determination means can be simplified.

  Further, in the blood pressure determination method, an electromagnetic valve connected to the two cuffs and discharging the gas at the same atmospheric pressure from the inside of the two cuffs discharges the gas while maintaining the same atmospheric pressure in the two cuffs. It is desirable to reduce the pressure on the left and right outer ears or their surroundings.

  By discharging the gas at the same atmospheric pressure with the electromagnetic valve, the pressure applied to the left and right outer ears or the periphery thereof can be reduced with the same pressure over time. Therefore, the reference of the pulse wave signal over time can be made equal on the left and right, and it is not necessary to perform processing such as matching the reference of the pulse wave signal with respect to the compression pressure on the left and right at the time of blood pressure determination. Therefore, for example, processing such as addition of pulse wave signals in the blood pressure determination means can be simplified.

  ADVANTAGE OF THE INVENTION According to this invention, the blood pressure meter and blood pressure determination method which improved the measurement precision of the blood pressure measurement in the outer ear or a part of minute part around the outer ear can be realized.

  Hereinafter, embodiments of the sphygmomanometer and the blood pressure determination method according to the present invention will be described in detail, but the present invention is not construed as being limited to the following description.

  FIG. 1 shows an example in which the sphygmomanometer according to the present embodiment is attached to the left and right outer ears or the tragus which is a part of the periphery thereof. FIG. 1 shows a state in which the living body 1 is viewed from above the head with the nose 2 of the living body 1 in front.

  The sphygmomanometer 100 according to the present embodiment includes cuff mounting portions 10a and 10b each having two cuffs 11a and 11b that compress the tragus 4a and 4b, which are part of the outer ears 3a and 3b of the living body 1, with equal compression pressure. In addition, the cuff mounting portions 10a and 10b are provided with an arc-shaped headband 14 that prevents the two cuffs 11a and 11b from being detached from the tragus 4a and 4b.

  The headband 14 has an arcuate shape and has a function of pressing the cuff mounting portions 10a and 10b against the tragus 4a and 4b from the left and right by an elastic force. For the headband 14, for example, a material such as plastic or metal can be applied. Moreover, it is good also as a structure which expands / contracts according to the magnitude | size of a head. Further, the mounting position of the headband 14 may be any position of the lower chin, the forehead, the top of the head, or the back of the head. For example, if the headband 14 is positioned on the lower jaw, the forehead, and the top of the head, the blood pressure monitor can be attached in the supine state of the living body 1, and if the headband 14 is positioned on the top of the head and the back of the head, the living body 1 It is possible to wear a sphygmomanometer in the state of prone. Further, the position of the headband 14 may be appropriately changed according to the use state of the sphygmomanometer 100 by moving the coupling portion between the headband 14 and the cuff mounting portions 10a and 10b.

  The cuff mounting portion 10a includes a cuff 11a that compresses the right tragus 4a, a support portion 12a that is paired with the cuff 11a, and the cuff 11a and the support portion 12a are arranged to sandwich the tragus 4a by the elastic force of the coil spring 13a. The clip 15a, and the cuff 11a and the support portion 12a sandwich the tragus 4a and press it. The cuff 11b that compresses the left tragus 4b has the same configuration as the cuff 11a that compresses the right tragus 4a.

  By adopting such a configuration, the cuffs 11a and 11b are not detached from the tragus 4a and 4b during the activity of the living body 1 and the measurement of blood pressure, and the reliability of blood pressure measurement can be ensured.

  Here, the details of the sphygmomanometer according to the present embodiment will be described with reference to FIG.

  FIG. 2 shows a schematic configuration diagram of the sphygmomanometer according to the present embodiment. In FIG. 2, the cuff attachment portion 10 a attached to the right tragus 4 a and 4 b is described, but in the present embodiment, the left cuff attachment portion 10 b shown in FIG. 1 is also attached to the cuff attachment shown in FIG. 2. The configuration is the same as that of the unit 10a.

  The sphygmomanometer 100 shown in FIG. 2 includes a light emitting element 21a and a light receiving element 22a as pulse wave detecting means for detecting a pulse wave from the cuff wearing part 10a and the tragus 4a which is a part of the outer ear, and a cuff 11a. As a blood pressure determination means for determining the blood pressure from the pump 23a for sending gas to the inside, the electromagnetic valve 24a for discharging gas from the inside of the cuff 11a, the pulse wave signal from the tragus 4a and the compression pressure value to the tragus 4a. And a CPU 28 for controlling the functions of the light emitting element 21a, the light receiving element 22a, the pump 23a, the electromagnetic valve 24a, and the blood pressure detecting unit 27. The pump 23b sends gas into the cuff 11b of the cuff attachment 10b attached to the left tragus 4b shown in FIG. 1, and the electromagnetic valve 24b shown in FIG. Gas is discharged from the inside of the cuff 11b of the cuff mounting portion 10b mounted on the pearl 4b.

  The cuff mounting portion 10a of the present embodiment shown in FIG. 2 has the clip 15a, the cuff 11a, and the support portion 12a as described in FIG. The clip 15a has a configuration in which the tragus 4a is sandwiched by the elastic force of the coil spring 13a, and has a handle 16a made of a material such as rubber for facilitating gripping the clip 15a. Further, the clip 15a has a housing part 17a for accommodating the cuff 11a. The housing portion 17a has a function of supporting the tragus 4a when the cuff 11a contracts, and prevents the clip 15a from being detached from the tragus 4a even when the living body is active. A non-expandable member is applied to the casing portion 17a so that the cuff 11a is not deformed by expansion. For example, a non-stretchable member such as plastic or metal can be applied.

  The cuff 11a of the present embodiment is formed of an elastic member and has a compression surface 29a that compresses the tragus 4a on the side of the opened surface of the housing portion 17a. The cuff 11a expands by sending gas from the pump 23a. And has a function of increasing the compression pressure of the tragus 4a. On the other hand, it has a function of reducing the compression pressure of the tragus 4a by discharging gas from the electromagnetic valve 24a. As the elastic member that becomes the cuff 11a, for example, an elastic member such as rubber or polyethylene film can be applied. These members have good adhesion to the tragus 4a which is a part of the outer ear, and do not damage the tragus 4a. In the present embodiment, the cuff 11a is expanded and contracted by the pressure of the gas inside the cuff 11a. However, if the tragus 4a can be compressed, for example, by pressure such as water pressure, hydraulic pressure, air pressure, etc. The tragus 4a may be pressed by moving the piston up and down, or the tragus 4a may be pressed by an electronic component such as a piezoelectric element that expands and contracts when a voltage is applied. Moreover, the structure which provides the thing similar to the cuff 11a instead of the support part 12a of FIG. 2, and applies a pressure from the upper and lower sides may be sufficient. In the present embodiment, the tragus 4a is sandwiched. However, a cuff that is inserted into the ear canal that is a part of the outer ear and expands inside the ear canal to compress the inner wall of the ear canal may be used. When the cuff inserted into the ear canal is applied, it is possible to make the wearing of the sphygmomanometer inconspicuous from the outside.

  The support portion 12a has a function of supporting the tragus 4a and pressing the tragus 4a together with the cuff 11a. As the support portion 12a, for example, a soft material such as rubber or felt can be applied. These materials are less deformed, can appropriately exert the force to support the tragus 4a that is a part of the outer ear, and do not damage the tragus 4a.

 Moreover, in this embodiment, it has the light emitting element 21a and the light receiving element 22a as a pulse wave detection means which each detects the pulse wave from the tragus 4a which is a part of outer ear. The light emitting element 21a is embedded in the support portion 12a so as to be in close contact with the tragus 4a. This is because, of the irradiation light 81 from the light emitting element 21a, the transmitted light 82 that passes through the inside of the tragus 4a is received by the light receiving element 22a with little loss of the amount of light received. Further, the light receiving element 22a is provided on the inner side of the compression surface 29a of the cuff 11a so as to be in close contact with the tragus 4a in order to reduce the loss of the amount of received light. It may be embedded outside the compression surface 29a. In order to detect the pulse wave of the tragus 4a, both the light emitting element 21a and the light receiving element 22a may be provided on either the support portion 12a or the cuff 11a. In this embodiment, it is set as the structure which detects the photoelectric pulse wave from the tragus 4a with the light emitting element 21a and the light receiving element 22a. The principle of photoelectric pulse wave detection will be described later.

 The pump 23a is connected to the cuff 11a by an air pipe 25a, and has a function of sending gas into the cuff 11a and increasing the pressure applied to the tragus 4a. In the present embodiment, the pump 23a also has a function of detecting the pressure inside the cuff 11a, and also serves as a pressure detection unit that detects the pressure applied to the tragus 4a by the cuff 11a. The electromagnetic valve 24a is connected to the cuff 11a via an air pipe 26a and has a function of discharging gas from the inside of the cuff 11a to reduce the pressure applied to the tragus 4a. In addition, it is good also as providing a pressure sensor separately for the detection of the compression pressure to the tragus 4a. For example, the compression pressure of the cuff 11a can be detected by providing a pressure sensor between the surface of the tragus 4a and the compression surface 29a of the cuff 11a. By setting it as such a structure, since the direct compression pressure to the tragus 4a by the cuff 11a can be detected, the precision of blood-pressure determination can be improved.

  The blood pressure detection unit 27 determines the blood pressure from the pulse wave signal from the tragus 4a detected from the light received by the light receiving element 22a and the pressure value applied to the tragus 4a detected by the pump 23a.

  Here, the detection principle of the photoelectric pulse wave by the light emitting element 21a and the light receiving element 22a will be described with reference to FIG. FIG. 3 shows an example of the result of measuring the photoelectric pulse wave in the process of reducing the pressure after pressing the tragus 4a shown in FIG. 3A shows a cuff pressure 32 and a blood pressure waveform 35 as compression pressure, and FIG. 3B shows a photoelectric pulse waveform 31 detected according to the cuff pressure 32. A photoelectric pulse wave waveform substantially similar to the waveform shown in FIG. 3 can also be obtained from the left tragus 4b shown in FIG.

  The irradiation light 81 irradiated to the tragus 4 a by the light emitting element 21 a shown in FIG. 2 is scattered by the blood cell 83 flowing through the blood vessel to the peripheral side of the tragus 4 a indicated by the arrow 84. The light receiving element 22 a receives the transmitted light 82 transmitted through the tragus 4 a among the light scattered by the blood cell 83. Here, since the speed of the blood cell 83 is accompanied by a speed change according to the heartbeat (that is, the heart rate of the living body), the transmission amount of the transmitted light 82 changes. Therefore, the photoelectric pulse wave as the flow velocity of the blood cell 83 can be detected by receiving the transmitted light 82 by the light receiving element 22 a and calculating the change in the transmission amount of the transmitted light 82 by the blood pressure detector 27. Since the light receiving element 22a receives the transmitted light 82 and detects a pulse wave, the pulse wave detection method is referred to as a transmission type photoelectric pulse wave method.

  Further, in the embodiment shown in FIG. 2, when both the light emitting element 21a and the light receiving element 22a are provided on either the support portion 12a or the cuff 11a, the irradiation light applied to the tragus 4a of the light emitting element is indicated by an arrow on the blood vessel. It is scattered by the blood cell 83 flowing to the peripheral side of the tragus 4a indicated by 84. Of the light scattered by the blood cell 83, the light receiving element receives the scattered light reflected by the tragus 4a. Here, since the speed of the blood cell 83 is accompanied by a speed change corresponding to the heartbeat, the amount of scattered light received by the light receiving element changes. Therefore, the photoelectric pulse wave as the flow velocity of the blood cell 83 can be detected by receiving the scattered light by the light receiving element and calculating the change in the amount of the scattered light received by the blood pressure detector. Since the light receiving element receives scattered light reflected by the blood cell 83 of the tragus 4a and detects a pulse wave, the pulse wave detection method is referred to as a reflective photoelectric pulse wave method.

  Here, the tragus 4a is pressed by the cuff 11a shown in FIG. 2, and is pressed until the amplitude of the photoelectric pulse wave waveform 31 shown in FIG. Thereafter, the cuff pressure that is the pressure inside the cuff 11a shown in FIG. 2 is reduced. Then, when the cuff pressure 32 shown in FIG. 3A becomes equal to or lower than a certain pressure, the amplitude of the photoelectric pulse wave waveform 31 shown in FIG. This time is T1, and the cuff pressure 32 (FIG. 3A) at that time is P1. When the pressure is further reduced, the flow rate of the blood cell 83 shown in FIG. 2 changes, and the amount of light received by the light receiving element 22a also changes. In the case of this embodiment, the intensity of the detected pulse wave increases as the change in the flow rate of the blood cell 83 increases. When a certain cuff pressure 32 (FIG. 3 (a)) is reached, the value of the photoelectric pulse waveform 31 becomes maximum as shown in FIG. 3 (b). The maximum time is T2, and the cuff pressure 32 (FIG. 3A) at that time is P2. When the cuff pressure 32 (FIG. 3A) is further decreased, the photoelectric pulse waveform 31 starts to decrease. Thereafter, the amplitude of the photoelectric pulse wave waveform 31 becomes constant. The blood pressure value can be determined with P1 as a value corresponding to systolic blood pressure and P2 as a value corresponding to diastolic blood pressure.

  When the photoelectric pulse wave is detected in the process of pressing the tragus 4a shown in FIG. 2, a photoelectric pulse wave waveform completely opposite to the graph shown in FIG. 3 is obtained. That is, in the process of increasing the cuff pressure, the state of the photoelectric pulse wave waveform at time T2 shown in FIG. 3 appears first, and the state of the photoelectric pulse wave waveform at time T1 appears later.

  In the present embodiment, as shown in FIG. 2, the photoelectric pulse wave from the tragus 4a is detected by the light emitting element 21a and the light receiving element 22a, but the blood vessel expands due to blood pressure when the tragus 4a is compressed. It is good also as detecting the pressure pulse wave obtained by contracting. In this case, as a method for detecting the pressure pulse wave, for example, a change in pressure inside the cuff 11a is detected. Further, in order to detect the systolic blood pressure value and the diastolic blood pressure value, a photoelectric pulse wave or a pressure pulse wave may be detected, and a Korotkoff sound may be detected. In this case, as a method for detecting the Korotkoff sound, for example, a microphone is provided inside the cuff 11a. The photoelectric pulse wave detection method, the pressure pulse wave detection method, and the Korotkoff sound detection method can be realized by ordinary techniques.

  Here, the blood pressure detection unit 27 shown in FIG. 2 reduces or increases the pressure applied to the left and right tragus 4a and 4b by the cuffs 11a and 11b shown in FIG. Based on the pressure wave detected by the pressure detection function of the pumps 23a, 23b (FIG. 2) corresponding to the pulse wave detected by the light emitting element and the light receiving element provided in the two cuffs 11a, 11b attached to the To determine systolic blood pressure, diastolic blood pressure or heart rate. In the blood pressure detection unit 27 as the blood pressure determination means, the validity of each pulse wave signal can be verified in advance by determining the blood pressure from the pulse wave signals obtained from the left and right tragus 4a and 4b. Therefore, the sphygmomanometer 100 according to the present embodiment has good blood pressure determination accuracy.

  The blood pressure detection unit 27 shown in FIG. 2 has systolic blood pressures of the left and right tragus 4a and 4b based on the pulse waves from the left and right tragus 4a and 4b and the pressure applied to the left and right tragus 4a and 4b. It is desirable to determine that there is an error when the left-right difference in either diastolic blood pressure or heart rate is greater than or equal to a predetermined threshold.

  It is estimated that the pulse wave signals from the left and right tragus 4a and 4b coincide with each other in the left and right tragus 4a and 4b. Therefore, in the blood pressure detection unit 27, by calculating the left-right difference of the systolic blood pressure, the diastolic blood pressure, or the heart rate obtained from the pulse wave signals from the left and right tragus 4a, 4b, the pulse waves of each other are calculated. It can be determined whether the signals match. In addition, the systolic blood pressure, the diastolic blood pressure, or the heart rate can be detected during blood pressure measurement according to the method of blood pressure determination, as will be described later.

  That is, when determining the blood pressure in the process of increasing the pressure applied to the tragus 4a, the diastolic blood pressure (corresponding to the cuff pressure at time T2 shown in FIG. 3) can be determined first, so the left and right ears Diastolic blood pressure by the beads 4a and 4b can be compared. On the other hand, when the blood pressure is determined in the process of reducing the pressure applied to the tragus 4a and 4b, the systolic blood pressure (corresponding to the cuff pressure at time T1 shown in FIG. 3) can be determined first. The systolic blood pressure of the tragus 4a and 4b can be compared. Further, the heart rate is determined between time T1 and time T2 shown in FIG. 3 both when increasing the pressure applied to the tragus 4a and 4b and when decreasing the pressure applied to the tragus 4a and 4b. be able to.

  Therefore, since it is not necessary to perform blood pressure measurement to the end, the sphygmomanometer 100 according to the present embodiment detects an error in blood pressure measurement at an early stage, thereby reducing the time required for blood pressure measurement.

  In addition, the blood pressure detection unit 27 illustrated in FIG. 2 desirably determines the blood pressure based on the added value of the pulse wave signals from the left and right tragus 4a and 4b and the compression pressure.

  The pulse wave signals from the left and right tragus 4a and 4b include, for example, noise caused by mechanical deviations such as deviations from the tragus 4a and 4b of the cuff 11a and 11b due to the movement of the living body, the light receiving element 22a, Electrical noise mixed in the output signal from 22b is included. This noise is presumed to be weakly correlated with each other. Since the signal waveform is voltage-added and noise is power-added, the addition of both pulse wave signals in the blood pressure detection unit 27 can cancel and reduce the noise. That is, when the pulse wave signals are added, the desired pulse wave can be obtained with a signal level approximately twice as high. On the other hand, if the noise contained in the desired pulse wave signal is not correlated with the noise contained in the pulse wave signal obtained from the left and right tragus 4a, 4b, the signal level is obtained as approximately √2. . Therefore, the S / N ratio of the pulse wave signal can be increased, and the blood pressure determination accuracy obtained from the pulse wave signal can be improved.

  Moreover, the pumps 23a and 23b are provided as in the present embodiment, and the two pumps 23a and 23b are used to send the gas having the same atmospheric pressure into the two cuffs 11a and 11b attached to the left and right tragus 4a and 4b. Is desirable. When determining the blood pressure in the process of increasing the compression pressure on the tragus 4a, 4b by sending the gas of the same pressure into the two cuffs 11a, 11b, the left and right tragus 4a, 4b can be pressed with the same pressure. Therefore, the reference of the pulse wave signal over time can be made equal on the left and right, and it is not necessary to cause the blood pressure detection unit 27 to perform processing such as matching the reference of the pulse wave signal with respect to the compression pressure on the left and right in advance. Therefore, for example, the blood pressure detection unit 27 can easily perform processing such as addition of a pulse wave signal.

  Further, as in the present embodiment, electromagnetic valves 24a and 24b are provided, and the inside of the cuffs 11a and 11b from the inside of the two cuffs 11a and 11b attached to the left and right tragus 4a and 4b by the two electromagnetic valves 24a and 24b. It is desirable to discharge gas while maintaining the same atmospheric pressure. When the blood pressure is determined in the process of reducing the pressure applied to the tragus 4a and 4b by simultaneously discharging gas from the inside of the two cuffs 11a and 11b, to the left and right tragus 4a and 4b over time. The compression pressure can be reduced at the same pressure. Therefore, the reference of the pulse wave signal over time can be made equal on the left and right, and it is not necessary to cause the blood pressure detection unit 27 to perform processing such as matching the reference of the pulse wave signal with respect to the compression pressure on the left and right in advance. Therefore, for example, the blood pressure detection unit 27 can easily perform processing such as addition of a pulse wave signal.

  Further, as in this embodiment, by providing the pump 23a and the electromagnetic valve 24a, a series of flows that increase and decrease the pressure inside the cuff 11a can be realized by the control of the CPU 28.

  Next, an operation method of the sphygmomanometer 100 according to the present embodiment and a blood pressure determination method in the sphygmomanometer 100 will be described. First, the case where blood pressure is determined in the process of increasing and decreasing the pressure applied to the tragus 4a will be described with reference to FIGS. Here, the case where the cuff 11a is attached to the tragus 4a which is a part of the outer ear of the living body will be described. In the present embodiment, the operation of the cuff attachment portion will be described only for the portion attached to the right tragus, but the operation of the left cuff attachment portion is the same as that of the right side.

  FIG. 4 shows an example of the control flow of the sphygmomanometer according to the present embodiment.

  First, the cuff mounting portion 10a is mounted on the tragus 4a by sandwiching the tragus 4a between the cuff 11a and the support portion 12a with the clip 15a shown in FIG. Then, the flow shown in FIG. 4 is started. First, the CPU 28 shown in FIG. 2 sets an initial compression pressure for compressing the tragus 4a (step S10 of the initial compression procedure 41 shown in FIG. 4). Here, as the initial compression pressure, for example, several values may be provided in advance, and the living body may select in advance according to the tendency of its own blood pressure value before blood pressure measurement. The blood pressure value may be referred to from a memory (not shown) and set to a value slightly larger than that value. By doing in this way, the tragus 4a is not excessively pressed and a burden is not imposed on the living body. Then, the CPU 28 operates the pumps 23a and 23b to send the gas into the left and right cuffs 11a and 11b, and starts the compression of the tragus 4a and 4b (step S11 shown in FIG. 4). The pump 23a raises the pressure surface 29a by gradually increasing the pressure inside the cuff 11a. The tragus 4a is clamped and compressed by the compression surface 29a and the support portion 12a. Moreover, with the start of compression, the light receiving element 22a detects the pulse wave of the tragus 4a (step S12 shown in FIG. 4). The detected pulse wave is stored in a memory (not shown). Here, while determining whether the initial compression pressure has been reached, the CPU 28 controls the gas delivery from the pump 23a and continues the compression (step S13 shown in FIG. 4). When the initial compression pressure is reached, the compression is stopped while maintaining the compression pressure (step S14 shown in FIG. 4). In step S11 shown in FIG. 4, the compression pressure at the time when the compression of the tragus is started is naturally set to a value smaller than the initial value of the compression pressure set in step S10.

  After stopping the compression, the CPU 28 determines the appropriateness of the compression pressure at the initial value and stores the amplitude of the pulse wave of the tragus 4a detected by the light receiving element 22a and a memory (not shown) in step S12 shown in FIG. A ratio with the maximum amplitude of the pulse wave stored in is calculated, and it is determined whether or not the ratio is equal to or less than a predetermined value (step S15 shown in FIG. 4). Here, when the calculated ratio is larger than the predetermined value, the CPU 28 determines that the blood flow has not stopped because the compression pressure by the initial value is insufficient, and resets the initial value (shown in FIG. 4). Step S16). The pump 23a recompresses to an initial value set higher by a predetermined value by the CPU 28 (steps S11, 12, 13, and 14 shown in FIG. 4). In step S15 shown in FIG. 4, the CPU 28 (FIG. 2) may confirm that the pulse wave amplitude stored in the memory (not shown) includes a pulse wave having a predetermined value or more. This is to ensure the certainty of the compression operation by the cuff 11a (FIG. 2).

  On the other hand, if the calculated ratio is equal to or less than the predetermined value, the CPU 28 shown in FIG. 2 determines that the compression pressure based on the initial value is appropriate, and proceeds to the next procedure. In the case where determination is made using the maximum pulse wave amplitude in step S15 shown in FIG. 4 as in this embodiment, it is necessary to store all pulse waves in a memory (not shown) until the initial value is reached in step S12. Instead, the maximum pulse wave amplitude value may be stored in a memory (not shown) so as to be updated. This storage leads to a reduction in memory capacity.

  In this embodiment, in step S15 shown in FIG. 4, the suitability of the compression pressure at the initial value is determined based on the ratio of the amplitudes. However, the compression pressure is determined based on whether the amplitude of the pulse wave is equal to or less than a certain value. It is good also as judging suitability. In this case, without storing the pulse wave in the memory (not shown) in step S12, when the amplitude of the pulse wave does not become a predetermined value or less due to the initial compression pressure in step S15, the process returns to step S10 to return to the initial value. You may make it increase by adding and compressing. By doing so, the certainty of blood pressure measurement can be ensured.

  Next, the CPU 28 shown in FIG. 2 starts the pressure reduction at a constant speed while operating the electromagnetic valves 24a and 24b to maintain the cuff pressures of the left and right cuffs 11a and 11b at the same pressure (the detection procedure shown in FIG. 4). 42 step S31). The cuff pressure is detected by the cuff pressure detection function of the pump 23a. By reducing the compression pressure to the tragus 4a with the same pressure by the electromagnetic valve 24a, the reference of the pulse wave signal in the time can be made equal on the left and right, and the reference of the pulse wave signal with respect to the compression pressure at the time of blood pressure determination in the blood pressure detection unit 27 It is not necessary to perform processing such as matching left and right in advance, and signal processing can be simplified.

  As the cuff pressure is reduced, the left and right pumps 23a and 23b detect the cuff pressure by the cuff pressure detection function (step S32 shown in FIG. 4). Further, the light emitting element 21a and the light receiving element 22a detect the pulse wave of the tragus 4a (step S33 shown in FIG. 4). The same applies to the left tragus 4b. The detected cuff pressure and pulse wave are stored in a memory (not shown). Then, after detecting the pulse wave, it is determined whether or not the pulse wave amplitude has reached a maximum value due to the reduced pressure (step S34 shown in FIG. 4). When this happens, the cuff pressure reduction is stopped (step S35 shown in FIG. 4). Here, when the pressure is reduced at a constant speed in step S31 shown in FIG. 4, it is not necessary to detect the cuff pressure in step S32. However, the reliability of blood pressure measurement can be ensured by providing step S32. it can.

  Thereafter, the blood pressure detection unit 27 shown in FIG. 2 reads the detected pulse wave values from the left and right tragus 4a and 4b stored in a memory (not shown) to determine systolic blood pressure (the pulse shown in FIG. 4). Step S41 of the wave validity detection procedure 43). Here, the systolic blood pressure can be determined from the photoelectric pulse waveform 31 (cuff pressure corresponding to time T1) shown in FIG. Thereafter, the difference Δhb between the systolic blood pressure values determined for the left and right tragus is calculated (step S42 shown in FIG. 4). Then, the difference Δhb between the calculated systolic blood pressure values is compared with a predetermined threshold value chb, and if it is equal to or larger than the predetermined threshold value chb, it is determined that there is an error (step S44 shown in FIG. 4), and the blood pressure determination is stopped. On the other hand, the difference Δhb between the systolic blood pressure values is compared with a predetermined threshold value chb, and if it is less than the predetermined threshold value chb, the validity of the detected pulse wave is satisfied and the process proceeds to the next procedure. In the present embodiment, the error is determined by comparing the systolic blood pressure by the left and right tragus, but the diastolic blood pressure is determined by determining the diastolic blood pressure in step S41 shown in FIG. Alternatively, the heart rate may be determined in step S41 and the heart rates may be compared with each other. It is presumed that the pulse wave signals from the left and right tragus match between the left and right tragus. To determine whether the pulse wave signals match each other by calculating the left-right difference in systolic blood pressure, diastolic blood pressure, or heart rate obtained from the pulse wave signals from the left and right tragus Can do. In addition, after determining an error in step S44, you may make it start blood pressure determination from step S10 again.

  In this embodiment, the error is determined after stopping the decompression in step S35. However, the systolic blood pressure and the heart rate are also determined between step S31 for starting the decompression and step S35 for stopping the decompression. Yes (see FIG. 3 (determined between times T1 and T2)). In this case, the error may be determined by comparing the systolic blood pressure values or the heart rates of the left and right tragus between step S31 and step S35. In this case, since it is not necessary to perform blood pressure measurement to the end, an error in blood pressure measurement can be detected at an early stage to shorten the time required for blood pressure measurement.

  After the comparison between the systolic blood pressure value difference Δhb and the predetermined threshold value chb, the blood pressure detection unit 27 shown in FIG. 2 reads out the pulse waves from the left and right tragus from a memory (not shown), The signals are added (step S51 of the blood pressure determination procedure 44 shown in FIG. 4). It is estimated that the noise of the pulse wave signals from the left and right tragus is weakly correlated with each other. Since the signal waveform is voltage-added and the noise is power-added, the blood pressure detection unit 27 adds both signals to cancel and reduce the noise to improve blood pressure determination accuracy. . Then, the blood pressure detection unit 27 determines the systolic blood pressure value and the diastolic blood pressure value of the living body from the added value of the pulse wave signal (step S52 shown in FIG. 4). Here, the systolic blood pressure and the diastolic blood pressure can be determined from the photoelectric pulse waveform 31 (cuff pressure corresponding to times T1 and T2) shown in FIG. Also, the heart rate may be determined from the photoelectric pulse waveform 31 in step S52 shown in FIG. Then, it is determined whether or not the blood pressure can be determined in step S53 shown in FIG. 4. If the blood pressure can be determined, the blood pressure determination value is output to a display (not shown) (step S55), and the blood pressure determination is terminated. If the blood pressure cannot be determined, an error is output (step S54) and the blood pressure determination is stopped. In addition, after outputting an error, you may make it start blood pressure determination from step S10 again.

  Next, the case where the blood pressure is determined in the process of increasing the pressure applied to the tragus 4a shown in FIG. 2 will be described with reference to FIGS. Here, the case where the cuff 11a is attached to the tragus 4a which is a part of the outer ear of the living body will be described. In the present embodiment, the operation of the cuff attachment portion will be described only for the portion attached to the right tragus, but the operation of the left cuff attachment portion is the same as that of the right side.

  FIG. 5 shows an example of a control flow of the sphygmomanometer according to the present embodiment.

  First, the cuff mounting portion 10a is mounted on the tragus 4a by sandwiching the tragus 4a between the cuff 11a and the support portion 12a with the clip 15a shown in FIG. Then, the flow shown in FIG. 5 is started. First, the CPU 28 shown in FIG. 2 operates the pumps 23a and 23b to send gas at the same atmospheric pressure into the left and right cuffs 11a and 11b at a constant speed, and starts compression of the left and right tragus (see FIG. 2). Step S71 of the detection procedure 51 shown in FIG. The pump 23a raises the pressure surface 29a by gradually increasing the pressure inside the cuff 11a. The tragus 4a is clamped and compressed by the compression surface 29a and the support portion 12a. Here, the left and right pumps 23a and 23b detect the cuff pressures of the left and right cuffs 11a and 11b by the cuff pressure detection function (step S73 shown in FIG. 5). Further, the light emitting element 21a and the light receiving element 22a detect the pulse wave of the tragus 4a (step S74 shown in FIG. 5). The detected cuff pressure and pulse wave are stored in a memory (not shown). This operation is repeated until the amplitudes of the pulse waves of the left and right tragus 4a and 4b are below a certain value (steps S75 and S76 shown in FIG. 5). By sending the gas of the same atmospheric pressure from the pumps 23a and 23b, the left and right tragus 4a and 4b can be pressed with the same pressure as time passes. Therefore, the reference of the pulse wave signal in the passage of time can be made equal on the left and right sides, and it is not necessary to perform processing such as matching the reference of the pulse wave signal with respect to the compression pressure on the left and right in advance, thereby simplifying the signal processing. Can do.

  Here, when compression is performed at a constant speed in step S71 shown in FIG. 5, it is not necessary to detect the cuff pressure in step S73. However, the reliability of blood pressure measurement can be ensured by providing step S73. it can. In the present embodiment, the compression is performed while determining whether or not the amplitude of the pulse wave has become a certain value or less in step S75. By making such a determination, the tragus 4a is not excessively pressed and the living body is not burdened. Of course, an appropriate compression pressure may be set in advance, and when the pressure is reached, the compression may be stopped in step S76. In step S75, the ratio between the maximum amplitude value of the pulse wave stored in the memory (not shown) in step S74 and the amplitude value of the pulse wave at step S75 is calculated, and whether or not the ratio is equal to or less than a predetermined value. It is good also as judging. Specifically, when the calculated ratio is larger than a predetermined value, the CPU 28 shown in FIG. 2 determines that the blood flow has not stopped because the compression pressure by the initial value is insufficient, and step S73 shown in FIG. On the other hand, when the calculated ratio is less than or equal to the predetermined value, the CPU 28 shown in FIG. 2 determines that the compression pressure based on the initial value is appropriate and stops the compression.

  Thereafter, the blood pressure detection unit 27 shown in FIG. 2 reads the detected pulse wave values from the left and right tragus 4a and 4b stored in a memory (not shown), and determines the diastolic blood pressure value (shown in FIG. 5). Step S81 of the pulse wave validity detection procedure 52). Here, the diastolic blood pressure can be determined from the photoelectric pulse waveform 31 (cuff pressure corresponding to time T2) shown in FIG. Thereafter, the difference Δlb between the diastolic blood pressure values determined for the left and right tragus is calculated (step S82 shown in FIG. 5). Then, the calculated difference Δlb between the diastolic blood pressure values is compared with a predetermined threshold value clb, and if it is equal to or larger than the predetermined threshold value clb, it is determined that there is an error (step S84 shown in FIG. 5), and the blood pressure determination is stopped. On the other hand, the difference Δlb in the diastolic blood pressure value is compared with a predetermined threshold clb, and if it is less than the predetermined threshold clb value, the validity of the detected pulse wave is satisfied and the process proceeds to the next procedure. In the present embodiment, the error is determined by comparing the diastolic blood pressure values by the left and right tragus, but the systolic blood pressure is determined by comparing the systolic blood pressure values in step S81 shown in FIG. Alternatively, the heart rate may be determined in step S81 and the heart rates may be compared with each other. It is presumed that the pulse wave signals from the left and right tragus match between the left and right tragus. To determine whether the pulse wave signals match each other by calculating the left-right difference in systolic blood pressure, diastolic blood pressure, or heart rate obtained from the pulse wave signals from the left and right tragus Can do. After determining the error, the blood pressure determination may be started again from step S71.

  In the present embodiment, the error is determined after the compression is stopped in step S76. However, the diastolic blood pressure value and the heart rate are also measured between step S71 for starting the compression and step S76 for stopping the compression. It can be determined (see FIG. 3 (determined between times T1 and T2)). In this case, an error may be determined by comparing the diastolic blood pressure values or heart rates of the left and right tragus between step S71 and step S76. In this case, since it is not necessary to perform blood pressure measurement to the end, an error in blood pressure measurement can be detected at an early stage to shorten the time required for blood pressure measurement.

  After the comparison between the diastolic blood pressure value difference Δlb and the predetermined threshold value clb, the blood pressure detection unit 27 shown in FIG. 2 reads out the pulse waves from the left and right tragus from a memory (not shown), The signals are added (step S91 of the blood pressure determination procedure 53 shown in FIG. 5). It is estimated that the noise of the pulse wave signals from the left and right tragus is weakly correlated with each other. Since the signal waveform is voltage-added and the noise is power-added, the blood pressure detection unit 27 adds both signals to cancel and reduce the noise to improve blood pressure determination accuracy. . The blood pressure detection unit 27 determines the systolic blood pressure value and the diastolic blood pressure value of the living body from the added value of the pulse wave signal (step S92 shown in FIG. 5). Here, the systolic blood pressure and the diastolic blood pressure can be determined from the photoelectric pulse waveform 31 (cuff pressure corresponding to times T1 and T2) shown in FIG. Also, the heart rate may be determined from the photoelectric pulse waveform 31 in step S92 shown in FIG. Then, it is determined whether or not the blood pressure has been determined (step S93). If the blood pressure has been determined, the blood pressure determination value is output to a display (not shown) (step S95), the blood pressure determination is terminated, and the blood pressure is determined. If not, an error is output (step S94) and blood pressure determination is stopped. In addition, after outputting an error, you may make it start blood pressure determination from step S71 again.

  Next, another embodiment in the case of determining the blood pressure in the process of increasing the pressure applied to the tragus 4a shown in FIG. 2 will be described with reference to FIGS. Here, the case where the cuff 11a is attached to the tragus 4a which is a part of the outer ear of the living body will be described. In the present embodiment, the operation of the cuff attachment portion will be described only for the portion attached to the right tragus, but the operation of the left cuff attachment portion is the same as that of the right side.

  FIG. 6 shows an example of a control flow of the sphygmomanometer according to the present embodiment.

  First, the cuff mounting portion 10a is mounted on the tragus 4a by sandwiching the tragus 4a between the cuff 11a and the support portion 12a with the clip 15a shown in FIG. Then, the flow shown in FIG. 6 is started. First, the CPU 28 shown in FIG. 2 sets an initial compression pressure for compressing the tragus 4a (step S101 of the initial value setting procedure 91 shown in FIG. 6). Then, the CPU 28 operates the pumps 23a and 23b to send the gas into the left and right cuffs 11a and 11b to start the compression of the left and right tragus (step S102 shown in FIG. 6). The pumps 23a and 23b detect the cuff pressure of the cuffs 11a and 11b by the cuff pressure detection function of the pumps 23a and 23b, and the compression pressure by the cuff pressure is, for example, 4/5 of the initial value (this value is the blood pressure and the cuff pressure. From this relationship, the gas is quickly changed (step S103 shown in FIG. 6). Then, the light receiving element 22a detects the pulse wave of the tragus 4 when it reaches 4/5 of the initial value (step S104 shown in FIG. 6). The detected pulse wave is stored in a memory (not shown). Since the stored pulse wave is at the stage when it reaches 4/5 of the initial value, it is assumed to be a 4/5 pulse wave.

  Thereafter, when the compression pressure reaches the initial value, the process proceeds to the next procedure (step S106 shown in FIG. 6).

  In the next procedure, the CPU 28 operates the pumps 23a, 23b to send gas to the cuffs 11a, 11b and start compression of the left and right tragus at a constant speed (step S141 of the detection procedure 92 shown in FIG. 6). ). In addition to the compression of the left and right tragus, the left and right pumps 23a and 23b detect the cuff pressure by the cuff pressure detection function (step S142 shown in FIG. 6). Further, the light emitting element 21a and the light receiving element 22a detect the pulse wave of the tragus 4a (step S143 shown in FIG. 6). The same applies to the left tragus 4b. The detected cuff pressure and pulse wave are stored in a memory (not shown). Then, the CPU 28 determines whether or not the amplitude of the pulse wave stored in the memory (not shown) in the past has become a certain value or less (step S144 shown in FIG. 6), and the amplitude of the pulse wave has become the certain value or less. When this happens, the gas delivery is stopped and the compression is stopped (step S145 shown in FIG. 6). Here, when compression is performed at a constant speed in step S141 shown in FIG. 6, the cuff pressure may not be detected in step S142, but the reliability of blood pressure measurement can be ensured by providing step S142. it can. Although the amplitude of the pulse wave is determined in step S144, the compression may be stopped in step S145 when the pressure exceeds a predetermined cuff pressure.

  Next, it is determined whether or not the initial value set in step S101 shown in FIG. 6 is appropriate. Specifically, it is determined whether or not the set initial value is less than or equal to the diastolic blood pressure value.

  The CPU 28 shown in FIG. 2 stores the amplitude of the 4/5 pulse wave stored in the memory (not shown) in step S104 shown in FIG. 6 and the memory (not shown) in step S143 to determine whether the initial value is appropriate. A ratio with the maximum amplitude of the photoelectric pulse wave is calculated, and it is determined whether the ratio is equal to or less than a predetermined value (step S146 shown in FIG. 6). If the calculated ratio is larger than the predetermined value, the CPU 28 determines that the initial value is larger than the diastolic blood pressure value, and resets the initial value (step S147 shown in FIG. 6). The electromagnetic valve 24a is depressurized to an initial value set lower by a predetermined value by the CPU 28 (step S148 shown in FIG. 6). And it returns to step S102 shown in FIG. 6, and starts blood-pressure determination.

  On the other hand, if the calculated ratio is less than or equal to the predetermined value, the CPU 28 determines that the initial value is less than or equal to the diastolic blood pressure value, and proceeds to the next procedure.

  Thereafter, the blood pressure detection unit 27 shown in FIG. 2 reads the detected pulse wave values from the left and right traguses stored in a memory (not shown) to determine the diastolic blood pressure value (valid pulse wave shown in FIG. 6). Step S231) of the sex detection procedure 93). Here, the diastolic blood pressure can be determined from the photoelectric pulse waveform 31 (cuff pressure corresponding to time T2) shown in FIG. Thereafter, the difference Δlb between the diastolic blood pressure values determined for the left and right tragus is calculated (step S232 shown in FIG. 6). The calculated diastolic blood pressure value difference Δlb is compared with a predetermined threshold value clb, and if it is equal to or greater than the predetermined threshold value clb, it is determined that there is an error (step S234 shown in FIG. 6), and the blood pressure determination is stopped. On the other hand, the difference Δlb in the diastolic blood pressure value is compared with a predetermined threshold clb, and if it is less than the predetermined threshold clb value, the validity of the detected pulse wave is satisfied and the process proceeds to the next procedure. In the present embodiment, the error is determined by comparing the diastolic blood pressure values by the left and right tragus, but the systolic blood pressure is determined by comparing the systolic blood pressure values in step S231 shown in FIG. Alternatively, the heart rate may be determined in step S231 and the heart rates may be compared with each other. It is presumed that the pulse wave signals from the left and right tragus match between the left and right tragus. To determine whether the pulse wave signals match each other by calculating the left-right difference in systolic blood pressure, diastolic blood pressure, or heart rate obtained from the pulse wave signals from the left and right tragus Can do. After determining the error, the blood pressure determination may be started again from step S101.

  In this embodiment, the error is determined after the compression is stopped in step S145. However, the diastolic blood pressure value and the heart rate are also determined between step S141 for starting the compression and step S145 for stopping the compression. It can be determined (see FIG. 3 (determined between times T1 and T2)). In this case, an error may be determined by comparing diastolic blood pressure values or heart rates of the left and right tragus between step S141 and step S145. In this case, since it is not necessary to perform blood pressure measurement to the end, an error in blood pressure measurement can be detected at an early stage to shorten the time required for blood pressure measurement.

  After the comparison between the diastolic blood pressure value difference Δlb and the predetermined threshold value clb, the blood pressure detection unit 27 shown in FIG. 2 reads out the pulse waves from the left and right tragus from a memory (not shown), The signals are added (step S373 of the blood pressure determination procedure 94 shown in FIG. 6). It is estimated that the noise of the pulse wave signals from the left and right tragus is weakly correlated with each other. Since the signal waveform is voltage-added and the noise is power-added, the blood pressure detection unit 27 adds both signals to cancel and reduce the noise to improve blood pressure determination accuracy. . Then, the blood pressure detection unit 27 determines the systolic blood pressure value and the diastolic blood pressure value of the living body from the added value of the pulse wave signal (step S374 shown in FIG. 4). Here, the systolic blood pressure and the diastolic blood pressure can be determined from the photoelectric pulse waveform 31 (cuff pressure corresponding to times T1 and T2) shown in FIG. Also, the heart rate may be determined from the photoelectric pulse waveform 31 in step S374 shown in FIG. Then, it is determined whether or not the blood pressure has been determined (step S375). If the blood pressure has been determined, the blood pressure determination value is output to a display (not shown) (step S377), the blood pressure determination is terminated, and the blood pressure is determined. If not, an error is output (step S376) and blood pressure determination is stopped. In addition, after outputting an error, you may make it start blood pressure determination from step S101 again.

  In addition, another embodiment of the operation method of the sphygmomanometer 100 and the blood pressure determination method in the sphygmomanometer 100 according to the present embodiment will be described. First, the case where the blood pressure is determined in the process of increasing and decreasing the pressure applied to the tragus 4a will be described with reference to FIGS. Here, the case where the cuff 11a is attached to the tragus 4a which is a part of the outer ear of the living body will be described. In the present embodiment, the operation of the cuff attachment portion will be described only for the portion attached to the right tragus, but the operation of the left cuff attachment portion is the same as that of the right side.

  FIG. 7 shows an example of a control flow of the sphygmomanometer according to the present embodiment.

  First, the cuff mounting portion 10a is mounted on the tragus 4a by sandwiching the tragus 4a between the cuff 11a and the support portion 12a with the clip 15a shown in FIG. Then, the flow shown in FIG. 7 is started. First, the CPU 28 shown in FIG. 2 operates the pumps 23a and 23b to send gas into the left and right cuffs 11a and 11b, and starts compression of the tragus 4a and 4b (pulse wave stop shown in FIG. 7). Step S110 of the procedure 61). The pump 23a raises the pressure surface 29a by gradually increasing the pressure inside the cuff 11a. The tragus 4a is clamped and compressed by the compression surface 29a and the support portion 12a. Here, while detecting whether the pulse wave amplitude of the tragus 4a has become a certain value or less, the CPU 28 controls the gas delivery from the pump 23a and continues the compression (step S120 shown in FIG. 7). Then, the pulse wave is detected by the light emitting element 21a and the light receiving element 22a in the process of further increasing the compression pressure, and when the amplitude of the pulse wave from the tragus 4a becomes a certain value or less, the compression is stopped while maintaining the compression pressure. (Step S130 shown in FIG. 7). Thus, by pressing while detecting the pulse wave in step S120, the tragus 4a is not excessively pressed, and the living body is not burdened.

  Next, the CPU 28 performs initial setting for blood pressure determination. First, the cuff pressure is detected when the pulse wave is stopped (step S210 of the initial setting procedure 62 shown in FIG. 7), and the time t is set to 0 (step S220 shown in FIG. 7). Remember. Then, the electromagnetic valve 24a is operated to start pressure reduction at the same pressure as the cuff pressures of the left and right cuffs 11a and 11b (step S310 of the detection procedure 63 shown in FIG. 7). The cuff pressure is detected by the cuff pressure detection function of the pump 23a shown in FIG. By reducing the compression pressure to the tragus 4a with the same pressure by the electromagnetic valve 24a, the reference of the pulse wave signal in the time lapse can be made equal on the left and right, and the reference of the pulse wave signal with respect to the compression pressure at the time of blood pressure determination in the blood pressure detection unit 27. It is not necessary to perform processing such as matching left and right in advance, and signal processing can be simplified.

  After starting the pressure reduction, the time t is set to t + Δt (step S320 of the detection procedure 63 shown in FIG. 7) and stored in the memory (not shown), and the cuff pressures of the left and right cuffs 11a and 11b at that time are detected. (Step S330 shown in FIG. 7) and stored in a memory (not shown). Then, pulse waves of the left and right tragus 4a and 4b are detected (step S340 shown in FIG. 7), and the detected values are stored in a memory (not shown). Then, it is determined whether or not the cuff pressure is less than a predetermined value (cp: for example, a pressure that does not burden the tragus 4a and 4b such as cp <10 mmhg) (step S350 shown in FIG. 7). When the value is less than the value, the cuff pressure reduction is stopped (step S360 shown in FIG. 7).

  Here, Δt is a sampling period. By appropriately setting the sampling period in this manner, the envelope of the photoelectric pulse wave waveform 31 shown in FIG. 3 can be directly stored in a memory (not shown), which facilitates later blood pressure determination.

  After that, the blood pressure detection unit 27 shown in FIG. 2 reads the detected pulse wave values from the left and right tragus 4a and 4b stored in a memory (not shown), and the systolic blood pressure (corresponding to time T1 shown in FIG. 3). (Cuff pressure to be performed) is determined (step S410 of the pulse wave validity detection procedure 64 shown in FIG. 7). Here, the systolic blood pressure value is determined from the photoelectric pulse wave (cuff pressure corresponding to the time T1 of the photoelectric pulse wave waveform 31 shown in FIG. 3) stored in the memory (not shown) in step S340 shown in FIG. be able to. Thereafter, the blood pressure detection unit 27 illustrated in FIG. 2 calculates a difference Δhb between the systolic blood pressure values determined for the left and right tragus (step S420 illustrated in FIG. 7). Then, the calculated systolic blood pressure value difference Δhb is compared with a predetermined threshold value chb, and if it is equal to or larger than the predetermined threshold value chb, it is determined that there is an error (step S440 shown in FIG. 7), and the blood pressure determination is stopped. On the other hand, the difference Δhb between the systolic blood pressure values is compared with a predetermined threshold value chb, and if it is less than the predetermined threshold value chb, the validity of the detected pulse wave is satisfied and the process proceeds to the next procedure. In the present embodiment, the error is determined by comparing the systolic blood pressure by the left and right tragus, but the diastolic blood pressure is determined by determining the diastolic blood pressure in step S410 shown in FIG. It is good also as comparing. It is presumed that the pulse wave signals from the left and right tragus match between the left and right tragus. By calculating the left-right difference between either the systolic blood pressure or the diastolic blood pressure obtained from the pulse wave signals from the left and right tragus, it is possible to determine whether the pulse wave signals of each other match. After determining the error, the blood pressure determination may be started again from step S110.

  In this embodiment, the error is determined after stopping the decompression in step S360. However, the systolic blood pressure can also be determined between step S310 for starting the decompression and step S360 for stopping the decompression. (See FIG. 3 (determined between times T1 and T2)). In this case, an error may be determined by comparing the systolic blood pressure values of the left and right tragus between Step S310 and Step S360. In this case, since it is not necessary to perform blood pressure measurement to the end, an error in blood pressure measurement can be detected at an early stage to shorten the time required for blood pressure measurement.

  After the comparison between the systolic blood pressure value difference Δhb and the predetermined threshold value chb, the blood pressure detection unit 27 shown in FIG. 2 reads out the pulse waves from the left and right tragus from a memory (not shown), The signals are added (step S510 of the blood pressure determination procedure 65 shown in FIG. 7). It is estimated that the electrical noise of the pulse wave signals from the left and right tragus is weakly correlated. Since the signal waveform is voltage-added and the noise is power-added, the blood pressure detection unit 27 adds both signals to cancel and reduce the noise to improve blood pressure determination accuracy. . Then, the blood pressure detection unit 27 determines the systolic blood pressure value and the diastolic blood pressure value of the living body from the added value of the pulse wave signal (step S520 shown in FIG. 7). Here, the systolic blood pressure and the diastolic blood pressure can be determined from the photoelectric pulse waveform 31 shown in FIG. 3 (cuff pressure corresponding to times T1 and T2 of the photoelectric pulse waveform 31 shown in FIG. 3). Then, it is determined whether or not the blood pressure can be determined in step S530 shown in FIG. 7. If the blood pressure can be determined, the blood pressure determination value is output to a display (not shown) (step S550), and the blood pressure determination is terminated. If the blood pressure cannot be determined, an error is output (step S540) and the blood pressure determination is stopped. In addition, after outputting an error, you may make it start blood pressure determination from step S110 again.

  Next, the case where the blood pressure is determined in the process of increasing the pressure applied to the tragus 4a shown in FIG. 2 will be described with reference to FIGS. Here, the case where the cuff 11a is attached to the tragus 4a which is a part of the outer ear of the living body will be described. In the present embodiment, the operation of the cuff attachment portion will be described only for the portion attached to the right tragus, but the operation of the left cuff attachment portion is the same as that of the right side.

  FIG. 8 shows an example of a control flow of the sphygmomanometer according to the present embodiment.

  First, the cuff mounting portion 10a is mounted on the tragus 4a by sandwiching the tragus 4a between the cuff 11a and the support portion 12a with the clip 15a shown in FIG. Then, the flow shown in FIG. 8 is started. First, the CPU 28 shown in FIG. 2 performs initial settings for blood pressure determination. First, the CPU 28 detects the cuff pressure before compressing the left and right tragus (step S610 of the initial setting procedure 71 shown in FIG. 8), and sets the time t to 0 (step S620 shown in FIG. 8). (Not shown).

  Then, the CPU 28 operates the pumps 23a and 23b shown in FIG. 2 to send the gas having the same atmospheric pressure into the left and right cuffs 11a and 11b, and starts the compression of the tragus 4a and 4b (shown in FIG. 8). Step S710 of the detection procedure 72). The pump 23a raises the pressure surface 29a by gradually increasing the pressure inside the cuff 11a. The tragus 4a is clamped and compressed by the compression surface 29a and the support portion 12a. Here, the CPU 28 sets the time t to t + Δt (step S720 shown in FIG. 8) and stores it in a memory (not shown). Further, the cuff pressures of the left and right cuffs 11a and 11b at that time are detected (step S730 shown in FIG. 8) and stored in a memory (not shown). Further, pulse waves from the left and right tragus 4a and 4b are detected by the light emitting element 21a and the light receiving element 22a (step S740 shown in FIG. 8), and the detected value is stored in a memory (not shown). This operation is repeated until the amplitudes of the pulse waves of the left and right tragus 4a and 4b become a certain value or less (steps S750 and S760 shown in FIG. 8). The cuff pressure is detected by the cuff pressure detection function of the pumps 23a and 23b. By sending the gas of the same atmospheric pressure from the pumps 23a and 23b, the left and right tragus 4a and 4b can be pressed with the same pressure as time passes. Therefore, the reference of the pulse wave signal in the passage of time can be made equal on the left and right sides, and it is not necessary to perform processing such as matching the reference of the pulse wave signal with respect to the compression pressure on the left and right in advance, thereby simplifying the signal processing. Can do. Further, in the present embodiment, the compression is performed while determining whether or not the amplitude of the pulse wave has become a certain value or less in step S750 shown in FIG. By making such a determination, the tragus 4a is not excessively pressed and the living body is not burdened. Of course, an appropriate compression pressure may be set in advance, and when the pressure is reached, the compression may be stopped in step S760.

  Here, Δt is a sampling period. By appropriately setting the sampling period in this manner, the envelope of the photoelectric pulse wave waveform 31 shown in FIG. 3 can be directly stored in a memory (not shown), which facilitates later blood pressure determination.

  After that, the blood pressure detection unit 27 shown in FIG. 2 reads the detected pulse wave values from the left and right tragus 4a and 4b stored in a memory (not shown), and the diastolic blood pressure value (at time T2 shown in FIG. 3). (Corresponding cuff pressure) is determined (step S810 of the pulse wave validity detection procedure 73 shown in FIG. 8). Here, the diastolic blood pressure can be determined from the photoelectric pulse wave (cuff pressure corresponding to the time T2 of the photoelectric pulse wave waveform 31 shown in FIG. 3) stored in a memory (not shown) in step S740. Thereafter, the blood pressure detection unit 27 illustrated in FIG. 2 calculates the difference Δlb between the diastolic blood pressure values determined for the left and right tragus (step S820 illustrated in FIG. 8). The calculated diastolic blood pressure value difference Δlb is compared with a predetermined threshold value clb, and if it is equal to or greater than the predetermined threshold value clb, it is determined that there is an error (step S840 shown in FIG. 8), and the blood pressure determination is stopped. On the other hand, the difference Δlb in the diastolic blood pressure value is compared with a predetermined threshold clb, and if it is less than the predetermined threshold clb value, the validity of the detected pulse wave is satisfied and the process proceeds to the next procedure. In the present embodiment, the error is determined by comparing the diastolic blood pressure values of the left and right tragus. However, the systolic blood pressure is determined and compared between the systolic blood pressure values in step S810 shown in FIG. It is good. It is presumed that the pulse wave signals from the left and right tragus match between the left and right tragus. By calculating the left-right difference between either the systolic blood pressure or the diastolic blood pressure obtained from the pulse wave signals from the left and right tragus, it is possible to determine whether the pulse wave signals of each other match. Note that after determining the error, the blood pressure determination may be started again from step S610.

  In this embodiment, the error is determined after the compression is stopped in step S760. However, the diastolic blood pressure can be determined between step S710 for starting the compression and step S760 for stopping the compression. (See FIG. 3 (determined between times T1 and T2)). In this case, an error may be determined by comparing the diastolic blood pressure values of the left and right tragus between step S710 and step S760. In this case, since it is not necessary to perform blood pressure measurement to the end, an error in blood pressure measurement can be detected at an early stage to shorten the time required for blood pressure measurement.

  After the comparison between the diastolic blood pressure value difference Δlb and the predetermined threshold value clb, the blood pressure detection unit 27 shown in FIG. 2 reads out the pulse waves from the left and right tragus from a memory (not shown), The signals are added (step S910 of the blood pressure determination procedure 74 shown in FIG. 8). It is estimated that the electrical noise of the pulse wave signals from the left and right tragus is weakly correlated. Since the signal waveform is voltage-added and the noise is power-added, the blood pressure detection unit 27 adds both signals to cancel and reduce the noise to improve blood pressure determination accuracy. . Then, the blood pressure detection unit 27 determines the systolic blood pressure value and the diastolic blood pressure value of the living body from the added value of the pulse wave signal (step S920 shown in FIG. 8). Here, the systolic blood pressure and the diastolic blood pressure can be determined from the photoelectric pulse waveform 31 shown in FIG. 3 (cuff pressure corresponding to times T1 and T2 of the photoelectric pulse waveform 31 shown in FIG. 3). Then, it is determined whether or not the blood pressure can be determined in step S930 shown in FIG. 8. If the blood pressure can be determined, the blood pressure determination value is output to a display (not shown) (step S950), and the blood pressure determination is terminated. If the blood pressure cannot be determined, an error is output (step S940) and the blood pressure determination is stopped. In addition, after outputting an error, you may make it start blood pressure determination from step S610 again.

  The sphygmomanometer and the blood pressure determination method of the present invention are mounted on the outer ear to measure blood pressure, and can also be used in beauty facilities or entertainment facilities.

It is the schematic which showed the example with which the blood pressure meter which concerns on 1 embodiment was mounted | worn with the tragus which is a part of the left and right outer ear or its periphery. It is a schematic structure figure showing one embodiment of a sphygmomanometer. It is the figure which showed one example of the result of having measured the photoelectric pulse wave in the process of decompressing after compressing the tragus which is a part of the outer ear. It is the figure which showed one Embodiment of the control flow of a blood pressure meter. It is the figure which showed one Embodiment of the control flow of a blood pressure meter. It is the figure which showed one Embodiment of the control flow of a blood pressure meter. It is the figure which showed one Embodiment of the control flow of a blood pressure meter. It is the figure which showed one Embodiment of the control flow of a blood pressure meter.

Explanation of symbols

1: Living body 2: Nose 3a: Right outer ear 3b: Left outer ear 4a: Right tragus 4b: Left tragus 10a: Right cuff wearing part 10b: Left cuff wearing part 11a: Right cuff 11b: Left Cuff 12a: right support 12b: left support 13a: right coil spring 13b: left coil spring 14: headband 15a: right clip 15b: left clip 16a: right handle 16b: left handle 17a: Right housing part 17b: Left housing part 21a: Right light emitting element 21b: Left light emitting element 22a: Right light receiving element 22b: Left light receiving element 23a: Right pump 23b: Left pump 24a: Right solenoid valve 24b: Left solenoid valve 25a, 26a: Right air pipe 27: Blood pressure detector 28: CPU
29a: Right compression surface 31: photoelectric pulse waveform 32: cuff pressure 35: blood pressure waveform 41: initial compression procedure 42: detection procedure 43: pulse wave validity detection procedure 44: blood pressure determination procedure 51: detection procedure 52: pulse wave Validity detection procedure 53: Blood pressure determination procedure 61: Pulse wave stop procedure 62: Initial setting procedure 63: Detection procedure 64: Pulse wave validity detection procedure 65: Blood pressure determination procedure 71: Initial setting procedure 72: Detection procedure 73: Pulse wave Validity detection procedure 74: Blood pressure determination procedure 81: Irradiation light 82: Transmitted light 83: Blood cell 84: Arrow 91: Initial value setting procedure 92: Detection procedure 93: Pulse wave validity detection procedure 94: Blood pressure determination procedure 100: Blood pressure monitor

Claims (10)

Two cuffs respectively attached to the left and right outer ears of the living body or the periphery thereof, and compressing the left and right outer ears or the periphery thereof with an equivalent compression pressure;
Two pulse wave detection means for detecting pulse waves from the left and right outer ears or their surroundings respectively compressed by the two cuffs;
Two pressure detection means for respectively detecting the pressure applied to the left and right outer ears or their surroundings by the two cuffs;
The pulse waves detected by the two pulse wave detecting means in a state where the compression pressure to the left and right outer ears or the periphery thereof by the two cuffs is decreased or increased, and the two pressures corresponding to the pulse waves Blood pressure determination means for determining systolic blood pressure, diastolic blood pressure or heart rate based on the compression pressure detected by the detection means;
A sphygmomanometer, comprising:   The blood pressure determination means determines that an error occurs when a left-right difference in any of systolic blood pressure, diastolic blood pressure, or heart rate of the left and right outer ears or their surroundings is equal to or greater than a predetermined threshold value. The sphygmomanometer according to claim 1.   3. The sphygmomanometer according to claim 1, wherein the blood pressure determination unit determines a blood pressure based on an added value of the pulse wave signals of the left and right outer ears or the periphery thereof and the compression pressure.   The apparatus further comprises a pump connected to the two cuffs to send a gas of the same atmospheric pressure into the two cuffs to increase the compression pressure to the left and right outer ears or the periphery thereof. 4. The blood pressure monitor according to any one of 3.   An electromagnetic valve is connected to the two cuffs and discharges gas from the inside of the two cuffs while maintaining the same atmospheric pressure in the two cuffs to reduce the compression pressure to the left and right outer ears or the periphery thereof. The sphygmomanometer according to claim 1, wherein:   A state in which two cuffs respectively attached to the left and right outer ears or the periphery thereof and compressing the left and right outer ears or the periphery thereof with the same compression pressure are reducing or increasing the compression pressure to the left and right outer ears or the periphery The two pressure detecting means for detecting the pulse waves detected by the two pulse wave detecting means for detecting the pulse waves from the left and right outer ears or their surroundings and the compression pressure for the left and right outer ears or their surroundings, respectively. A blood pressure determination method, wherein blood pressure determination means determines systolic blood pressure, diastolic blood pressure, or heart rate based on a compression pressure detected corresponding to the pulse wave.   The blood pressure determination means further determines that an error occurs when a difference between systolic blood pressure, diastolic blood pressure, or heart rate of the left and right outer ears or their surroundings is equal to or greater than a predetermined threshold value. 2. The blood pressure determination method according to 1.   The blood pressure determination method according to claim 6 or 7, wherein the blood pressure determination means determines a blood pressure based on an added value of the pulse wave signals of the left and right outer ears or the periphery thereof and the compression pressure.   7. A pump connected to the two cuffs and sending a gas at the same atmospheric pressure into the two cuffs sends out the gas to increase the pressure applied to the left and right outer ears or their surroundings. To 8. The blood pressure determination method according to any one of 8 to 8.   A solenoid valve connected to the two cuffs and discharging gas at the same atmospheric pressure from the inside of the two cuffs discharges gas while maintaining the same atmospheric pressure in the two cuffs to the left and right outer ears or their surroundings. The blood pressure determination method according to claim 6, wherein the compression pressure is decreased.

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